Medizinische Universität Graz Austria/Österreich - Forschungsportal - Medical University of Graz
Gewählte Publikation:
Gilg, M.
Origin, histology and endoscopic findings of secondary tumors in the gastrointestinal tract
Doktoratsstudium der Medizinischen Wissenschaft; Humanmedizin; [ Dissertation ] Graz Medical University; 2018. pp.
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- Autor*innen der Med Uni Graz:
- Betreuer*innen:
- Eherer Andreas
- Hoegenauer Christoph
- Langner Cord
- Altmetrics:
- Abstract:
- Background: Secondary tumors of the gastrointestinal tract (GIT) are a rare finding with a dismal prognosis because they are only found with advanced cancers. This study aimed to investigate clinical, endoscopic and pathological features of secondary tumors diagnosed during gastroscopy or colonoscopy. Methods: A retrospective database search retrieved 217 patients with a secondary tumor of the GIT who had undergone endoscopy in 12 hospitals in southern Austria with histologically confirmed diagnosis from the Institute of Pathology, Medical University of Graz, Austria. Results: Malignant melanoma (n=33, 15%), breast (n=32, 15%) and pancreatic cancer (n=27, 12%) were the most common corresponding primaries. The most frequent anatomi-cal site was the stomach (n=76, 35%), followed by duodenum (n=54, 25%) and rectum (n=53, 24%). Time intervals between the initial diagnosis of a primary tumor and a second-ary tumor ranged between 0 and 251 months (median 19 months). Fifty-six percent (n=122) of secondary tumors had invaded directly from extragastrointestinal sites (includ-ing peritoneal carcinomatosis), while 44% (n=95) of secondary lesions had spread via the vascular route, depending on both tumor site and corresponding primaries. When a defini-tive primary tumor was already known (n=168 patients), a secondary tumor was considered as a differential diagnosis in only 48% (n=80) of cases. Conclusions: Malignant melanoma, breast cancer and pancreatic cancer are the most common underlying primary tumors of metastases within the GIT. As clinical presentation and endoscopic findings are highly unspecific, biopsies and histological workup are indi-cated for every suspicious lesion with the GIT to avoid diagnostic delay and misclassifica-tion.